Diagnosis and Treatment of CAD in Severe PAD After Lower Extremity Revascularization

Inclusion Criteria: * Male or female 50 to 85 * Severe intermittent claudication with ABI \< 0.6 or monophasic waveform if non-compressible and TBI \< 0.6 * Chronic limb threatening ischemia (CLTI) with pain at rest (Rutherford Category 4) with ABI \< 0.5 or TBI \< 0.6 * CLTI with minor tissue loss (Rutherford Category 5) with ABI \< 0.5 or TBI \< 0.6 * Completed Lower Extremity Revascularization and enrolled within 45 days * The patient or legal representative will provide informed written consent * The patient has a life expectancy of at least 1 year Exclusion Criteria: * Major tissue loss of the ischemic limb (Rutherford Category 6) * Uncompensated congestive heart failure (NYHA class IV) * Myocardial infarction or stroke within the past 90 days * Prior coronary artery bypass graft (CABG) revascularization surgery * Prior percutaneous coronary intervention (PCI) with angioplasty or stenting * Presence of a pacemaker * Congestive heart failure with Ejection Fraction \< 30% * Elevated liver function tests more than twice the upper limit of normal * Severe Chronic renal disease (Glomerular Filtration Rate, GFR \< 30) or on hemodialysis * Pregnancy, Human Immunodeficiency Virus, or organ transplant recipients * Current malignancy or malignancy within the last two years unless the treating oncologic physician provides prognosis of an anticipated 2- year survival (i.e., adequately treated non-melanoma skin cancer or adequately treated prostate cancer without metastatic disease) * Any condition the review panel determines would make the patient unsuitable for participation in the study